Department of Medicine, UCMS and GTB Hospital, Delhi.
Hamdard Institute of Medical Sciences and Research, New Delhi, India.
Disaster Med Public Health Prep. 2022 Oct;16(5):1889-1896. doi: 10.1017/dmp.2021.85. Epub 2021 Mar 25.
Several aspects of the coronavirus disease 2019 (COVID-19) pandemic remain ambiguous, including its transmission, severity, geographic, and racial differences in mortality. These variations merit elaboration of local patterns to inform wider national policies.
In a retrospective analysis, data of patients treated at a dedicated COVID hospital with moderate and severe illness during 8 wk of the pandemic were reviewed with attention to mortality in a competing risks framework.
A total of 1147 patients were hospitalized, and 312 (27.2%) died in hospital. Those who died were older (56.5 vs 47.6 y; < 0.0001). Of these, 885 (77.2%) had tested positive on reverse transcriptase polymerase chain reaction (RT-PCR), with 219 (24.2%) deaths (incidence rate, 1.9 per 100 person-days). Median time from onset of symptoms to death was 11 days. A competing risks analysis for revealed an adjusted cause-specific hazard ratio of 1.4 for each decade increase in age.
This retrospective analysis provides broad patterns of disease presentation and mortality. Even COVID test-negative patients will receive treatment at dedicated facilities, and 33% presenting cases may die within the first 72 h, most with comorbid illness. This should be considered while planning distribution of services for effective health-care delivery.
新冠病毒病（COVID-19）大流行仍有许多不明之处，包括其传播、严重程度、地理和种族差异导致的死亡率。这些差异值得对当地模式进行阐述，以告知更广泛的国家政策。
在一项回顾性分析中，对一家专门的 COVID 医院在大流行的 8 周内收治的中度和重度疾病患者的数据进行了回顾，重点关注竞争风险框架下的死亡率。
共有 1147 名患者住院，312 名（27.2%）在医院死亡。死亡患者年龄较大（56.5 岁比 47.6 岁；<0.0001）。其中，885 名（77.2%）经逆转录酶聚合酶链反应（RT-PCR）检测呈阳性，219 名（24.2%）死亡（发病率为每 100 人-日 1.9 人）。从症状发作到死亡的中位时间为 11 天。对 进行竞争风险分析表明，年龄每增加 10 岁，调整后的特定病因危险比为 1.4。
这项回顾性分析提供了疾病表现和死亡率的广泛模式。即使是 COVID 检测阴性的患者也将在专门的设施接受治疗，33%的就诊病例可能在最初的 72 小时内死亡，其中大多数伴有合并症。在规划服务分配以有效提供医疗服务时，应考虑这一点。
